Editing Maternal and Newborn Nursing (section)

=== Bleeding disorders ===

{| class="wikitable"
! !! Placenta previa !! Placental abruption
|-
| Bleeding || Painless, bright red, sudden onset || Painful, often dark red; may be '''concealed''' with little visible blood
|-
| Uterus || Soft, nontender, relaxed || Rigid, board-like, tender; frequent low-amplitude contractions
|-
| Key risk factors || Prior cesarean or uterine surgery, prior previa, multiparity, multiple gestation, advanced age, smoking || Hypertension and preeclampsia, cocaine use, abdominal trauma, smoking, prior abruption, PPROM
|-
| Critical nursing rule || '''No vaginal or digital cervical exam''' || Monitor for DIC and hypovolemic shock; prepare for possible emergency birth
|}

Other first-trimester bleeding causes include spontaneous abortion, '''ectopic pregnancy''' (unilateral pelvic pain, missed period, positive hCG, possible referred shoulder pain and syncope from hemoperitoneum; a surgical emergency if ruptured), and '''gestational trophoblastic disease''' (molar pregnancy: markedly elevated hCG, uterus larger than dates, grape-like vesicles, hyperemesis, early-onset hypertension; requires hCG follow-up and strict contraception because of choriocarcinoma risk).